0000849146-20-000064.txt : 20200403 0000849146-20-000064.hdr.sgml : 20200403 20200403105101 ACCESSION NUMBER: 0000849146-20-000064 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20200401 FILED AS OF DATE: 20200403 DATE AS OF CHANGE: 20200403 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jensen Darren Jay CENTRAL INDEX KEY: 0001642848 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35647 FILM NUMBER: 20772140 MAIL ADDRESS: STREET 1: C/O LIFEVANTAGE CORPORATION STREET 2: 9785 SOUTH MONROE ST. SUITE 300 CITY: SANDY STATE: UT ZIP: 84070 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Lifevantage Corp CENTRAL INDEX KEY: 0000849146 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 841097796 STATE OF INCORPORATION: DE FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: 9785 S. MONROE STREET STREET 2: SUITE 300 CITY: SANDY STATE: UT ZIP: 84070 BUSINESS PHONE: 801-432-9000 MAIL ADDRESS: STREET 1: 9785 S. MONROE STREET STREET 2: SUITE 300 CITY: SANDY STATE: UT ZIP: 84070 FORMER COMPANY: FORMER CONFORMED NAME: LIFELINE THERAPEUTICS, INC. DATE OF NAME CHANGE: 20041019 FORMER COMPANY: FORMER CONFORMED NAME: YAAK RIVER RESOURCES INC DATE OF NAME CHANGE: 19920703 FORMER COMPANY: FORMER CONFORMED NAME: ANDRAPLEX CORP DATE OF NAME CHANGE: 19920406 4 1 wf-form4_158592544343324.xml FORM 4 X0306 4 2020-04-01 0 0000849146 Lifevantage Corp LFVN 0001642848 Jensen Darren Jay 9785 SOUTH MONROE STREET, SUITE 400 SANDY UT 84070 1 1 0 0 Chief Executive Officer Common Stock 2020-04-01 4 M 0 4726 0 A 502758 D Common Stock 2020-04-01 4 F 0 8673 10.25 D 494085 D Performance Stock Units 2020-04-01 4 M 0 4726 0 D Common Stock 4726.0 23630 D On January 8, 2019, the reporting person was granted PSUs which vest only to the extent the specified financial performance criteria are achieved and subject to the reporting person's continued service with the issuer, as follows: (i) 1/2 of the earned award vested on the first anniversary of the grant date and (ii) an additional 1/12 of the earned award will vest as of the first day of each calendar quarter thereafter. The reporting person initially reported the number of shares that were eligible to be earned at target-level performance achievement. The performance criteria were achieved at a level above target; accordingly, the reporting person is eligible to earn 162% of the target number of units. The actual number of shares that vested on the reported transaction date was 162% of the at-target number of shares subject to vesting on that date and the number of PSUs beneficially owned following the reported transaction has been updated to reflect 162% of the target number of units. Performance Stock Units ("PSUs") convert into common stock on a one-for-one basis. These shares were withheld to satisfy tax withholding obligations in connection with the vesting of two stock unit awards and one PSU award granted on January 8, 2019. /s/ Darren Jay Jensen 2020-04-03